HIV and Coronary Heart Disease

Human Immunodeficiency Virus Infection–Related Heart Disease

“…1,2 Adjusting for age, smoking, and cocaine abuse are the strongest risk factors for CAD and ACS among HIV-infected patients. 3,4 Smoking is the strongest predictor of CAD in HIV-infected patients, and the rate of smoking among this population is 2 to 3 times higher than in the general population. 4 Cocaine abuse is common in North America and Europe, and it has been associated with accelerated CAD secondary to vasospasm and atherosclerosis.…”

“…1,2 Certain antiretroviral medications, especially PIs and NRTIs, have been linked to metabolic dysregulation (increased insulin resistance, dyslipidemia, and lipodystrophy) through a direct impact on lipid and glucose metabolism. 2,3,7 PIs lead to decreasing levels of high-density lipoproteins and to increasing levels of triglycerides. 2 The Data Collection in the Adverse Effects of Anti-HIV Drugs (D:A:D) study found an increased risk of CAD and ACS in patients taking PIs that was attributed to these dysmetabolic effects.…”

“…1 In addition to traditional risk factors such as smoking and family history, HIV has both direct and indirect effects on the heart; it causes an acute inflammatory response, leads to chronic cellular changes, and is an independent risk factor for CVD. [1][2][3][4] In addition, the antiretroviral medications used in the management and treatment of HIV/AIDS have significant cardiovascular side effects, including metabolic dysregulation that leads to dyslipidemia and atherosclerosis. [1][2][3][4] The pathophysiologic effects of HIV/AIDS on the heart are summarized in Box 1.…”

“…[1][2][3][4] In addition, the antiretroviral medications used in the management and treatment of HIV/AIDS have significant cardiovascular side effects, including metabolic dysregulation that leads to dyslipidemia and atherosclerosis. [1][2][3][4] The pathophysiologic effects of HIV/AIDS on the heart are summarized in Box 1. Altogether, these factors have changed the course of CVD in HIV-infected patients.…”

Gestione del rischio cardiovascolare nel paziente HIV positivo

“…e alcuni marcatori di disfunzione endoteliale (spessore medio intimale carotideo, calcio coronarico, velocità di polso, ecc.) (19,20). L'analisi di questi marcatori può essere utile nei pazienti a rischio cardiovascolare intermedio (compreso tra 2.5 e 7.5%, secondo lo score ACC-AHA) per ricollocarli nella fascia a basso (<2.5%) o ad alto rischio (>7.5%) e modulare di conseguenza l'intensità dell'intervento terapeutico.…”